妊娠期亚临床甲状腺功能减退症对妊娠结局及围产儿的影响

Effects of subclinical hypothyroidism on maternal and perinatal outcomes during pregnancy

目的探讨妊娠期亚临床甲状腺功能减退症(简称甲减)对妊娠结局及围产儿的影响方法纳入2014年3月~2016年3月在复日一大学附属上海市第任人民医院及上海市闵行区吴泾阪院分娩的妊赈期亚临床甲减患者514例和妊娠期甲减患者129例,随机选取同期分娩的止常孕妇1201例作为对照组,分析3组研究对象的临床资料进一步根据是否接受甲状腺素替代治疗将妊娠期亚临床甲减组分为治疗组和未治疗组,分析4组研究对象的妊娠结局及围产儿情况结果妊娠期亚临床甲减组、奸娠期甲减组和对照组在年龄、胎次、妊娠期髙血压及妊娠期糖尿病患病率方面比较差异均无统计学意义(P>0.05)妊娠期甲减组的什油三酯(TG)、总胆固醇(TC)、髙密度脂蛋白胆固醇(HDL-C)水平均高于妊娠期亚临床甲减组及对照组(P<0.05):妊娠期亚临床川减组及妊娠期甲减组甲状腺过氧化酶抗体(TPOA1))阳性率均明显高于对照组(P<0.05)妊娠期亚临床甲减治疗组和未治疗组、妊娠期甲减组及对照组的阿普加评分(Apgar评分)及巨大儿、流产、死产、急产、产后出血、侧切、早产、新生儿畸形、出生低体重、先天性甲减发生率比较总界均无统计学意义(P>0.05)结论妊娠期亚临床甲减患者TPOAb阳性率较高:妊娠期亚临床甲减对妊娠结局及围产儿未产生明显影响。

Objective To investigate the effects of subclinical hypothyroidism on maternal and perinatal outcomes during pregnancy. Methods From March 2014 to March 2016,514 patients with subclinical hypothyroidism and 129 patients with hypothyroidism during pregnancy who delivered in Shanghai fifth people's hospital affiliated to Fudan university and Wujing hospital of Minhang district of Shanghai were enrolled. A total of 1201 healthy women who delivered during the same period were randomly selected as control group. The clinical information of 3 groups weir compared. Subclinical liypothyroidisni group was further divided into treatment group and untreatnirnt group according to whether receiving thyroxine replacement therapy. Compare maternal complications and neonatal outcomes between those 4 groups. Results The age, parity, morbidity rate of gestational hypertension and gestational di abet e s were not significantly different among those subclinical hypothyroidism,hypothyroidism group and control group( P >0.05 ). Triglyceride (TG), total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) in the hypothyroidism group were higher than those in the subclinical hypothyroidism group and the conirol group( P <0.05 ). The rate of thyroid peroxidase antibody (TPOAb) positive in subclinical liypotlivroidism group and hypothyroidism group were significantly higher than those in control group (P < 0.05 ). Apgar score, the incidence of macTosomia, abortion, stillbirth, emergency labor, postpartum henioiTlnigc, laleial resection, preterm birth, neonatal inalformation. low birth weight and congenital hvpotlivroidisni were not significantly differrnl between the subclinical hypothyroidism treated group and the ii nt real rd group, the hypothyroidism group and the normal control group ( P > 0.05 ). Conclusion flic TPOAI)j)ositive rate is higher in subclinical hypothyroidism pregnant women. Subclinical hypothyroidism has no obvions influence on pregnancy outcome and perinatal.